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治疗首发精神病——服务使用者的视角:焦点小组评估

Treating first episode psychosis--the service users' perspective: a focus group evaluation.

作者信息

O'Toole M S, Ohlsen R I, Taylor T M, Purvis R, Walters J, Pilowsky L S

机构信息

Institute of Psychiatry, London and South London and Maudsley (NHS) Trust, UK.

出版信息

J Psychiatr Ment Health Nurs. 2004 Jun;11(3):319-26. doi: 10.1111/j.1365-2850.2004.00730.x.

Abstract

UK national guidance has prioritized developing specialist services for first episode psychosis. Such services are in the early stages of development and a definitive treatment model has yet to be established. The aim of this study was to explore service users' experiences of a first episode intervention designed along evidence-based 'best practice' guidelines and to establish specific elements seen as effective to help inform future service planning and provision. Twelve users of a specialist first episode service participated in focus groups. These were then analyzed using Interpretative Phenomenological Analysis, a specialized form of content analysis. Key elements identified by the service users included the 'human' approach as a key to the recovery process, being involved in treatment decisions, flexibility of appointments, high nurse to patient ratio, reduction in psychotic symptoms, increased confidence and independence and the provision of daily structure. To our knowledge, this is the first systematic qualitative evaluation of users' experience of a specialist first episode treatment intervention. Our findings indicate that adherence to best practice guidelines was appreciated. Regular focus groups provide a continuous audit cycle incorporating service improvements in line with government recommendations, centrally informed by the service users' and caregivers' perspective.

摘要

英国国家指南已将为首发精神病患者发展专科服务列为优先事项。此类服务尚处于发展初期,尚未建立明确的治疗模式。本研究的目的是探讨服务使用者对依据循证“最佳实践”指南设计的首发干预措施的体验,并确定被视为有效的具体要素,以帮助为未来的服务规划和提供提供参考。12名专科首发服务的使用者参加了焦点小组。随后采用解释现象学分析(一种专门的内容分析形式)对这些内容进行了分析。服务使用者确定的关键要素包括“人性化”方法是康复过程的关键、参与治疗决策、预约的灵活性、护士与患者的高比例、精神病症状的减轻、信心和独立性的增强以及日常安排的提供。据我们所知,这是对专科首发治疗干预措施使用者体验的首次系统定性评估。我们的研究结果表明,遵循最佳实践指南受到赞赏。定期的焦点小组提供了一个持续的审核周期,结合符合政府建议的服务改进措施,这些改进措施以服务使用者和照顾者的视角为核心依据。

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